Diabetes & COVID-19 Webinar

The CDC recommends people with diabetes closely follow their diabetes care plan for better blood sugar control. Join Dr. Nira Madisi, board certified in Endocrinology at Bayhealth, and Dr. Anita Raghuwanshi, board certified in Endocrinology, Diabetes, & Metabolism at Cape Regional Physicians Associates, for a free one-hour webinar discussing how COVID-19 impacts people with diabetes and how best to follow the CDC's recommendation.

Transcript

1. COVID-19 and Diabetes from a patient perspective An Initiative of the Delaware Diabetes Coalition Anita Raghuwanshi, MD, FACP, FACE, CDE - Endocrinologist, Cape Regional Physicians Associates Nira Madisi, MD - Endocrinologist, Bayhealth Medical
2. What is COVID-19? • COVID-19 • Coronavirus Disease 2019 • Name of the disease state caused by SARS-CoV2 • SARS-CoV-2 is the name of the virus • Severe Acute Respiratory Syndrome Coronavirus-2 • Corona = Crown • There are many coronaviruses that cause mild to moderate respiratory disease such as the common cold
3. Just another flu? Think again… • The ‘Flu’ is caused by viruses from the influenza family • Humans have evolved alongside the influenza virus and have a fairly predictable response • A typical flu will last 7-14 days and is characterized by fever, muscle aches, and upper respiratory symptoms. • Superinfection with bacteria can cause pneumonia • Only the frail tend to have serious consequences (except in H1N1) • CoVid-19 can be much more unpredictable than the flu
4. How are the symptoms of CoVid different than flu? • In addition to the usual high Fever, bodyache, Cough, and shortness of breath, CoVid can have many different presentations. • CoVid can present as just Nausea and Vomiting, without respiratory symptoms (10%) • CoVid can present as loss of smell or loss of taste • CoVid produces a highly inflammatory state in the body which can lead to blood clots • CoVid can present stroke in some people, without any other symptoms • CoVid can give you Hypoxia (low blood oxygen) without pneumonia • Children with CoVid may present with toxic shock / Kawasaki’s disease (heart inflammation)
5. The timeline of CoVid is also different • This virus is spreading fast because the first 5 days are usually asymptomatic (2-14 days), and the asymptomatic phase is often the most contagious. (some people are spreading it without ever becoming symptomatic) • Takes a minimum of 14 days to recover • Patients sick enough to be hospitalized usually take 3-6 weeks to recover • Reports of many patients from Italy who still have intermittent symptoms (fever, fatigue, bone pain, shortness of breath) 3 months later
6. Why is this coronavirus so severe? • This is a new type of virus. Humans have no immunity towards it. • Called a “chimera” because it came from different animal viruses mixing • It is thought that the 1918 influenza pandemic resulted because a chicken virus and a human virus mutated in a pig in Kansas, USA • Due to people and animals living closer together, there are parts of the world at a higher risk of future viruses that can jump from animals to humans. This includes parts of the USA.
7. Stay Calm but Prepared 1.) The best way to survive CoVid is to not get it. • We’ll review ways to not get infected 2.) Most people who get CoVid will be ok unless you are in a high risk group • Who’s high risk? • How to lower your risk 3.) What to do if you get CoVid?
8. How does it spread? • Transmission is primarily person-to-person • Mainly through large respiratory droplets produced when an infected person coughs or sneezes • Contact (fomite to face) • Fecal-oral? • • Transmission dependent on: • Closeness (within 6 feet) • Duration of exposure (10 minutes or more) • Exposure to droplet aerosolization • Masking • Cloth masks keep you from touching your face • Prevent you from spreading large droplets, • Don’t stop micro droplets or aerosols • (Role of social distancing)
9. Why is Social Distancing Important Everyone has a role to play in slowing the spread and protecting themselves, their family, and their community. This will help to decrease the number of DEATHS due to COVID-19 https://www.cdc.gov/coronavirus/2019-ncov/prevent-getting-sick/social-distancing.html
10. Why is Social Distancing Important
11. Who is at high risk of severe disease?
12. Are Diabetics at higher risk of getting CoVid? • To clarify, being diabetic does not increase your risk of catching SARS-CoV-2 • However, if you do catch SARS- CoV-2, your risk of having a severe course is higher • A severe course means the need for hospitalization, Nasal Oxygen, being put on a ventillator, and double the risk of death.
13. How do I lower my risk if I have diabetes? • Studies show that people whose blood sugars are >180mg/dL fared the worst. • Otherwise the effect of diabetes is relatively mild on survival statistics • Work with your provider and diabetes care team to make sure your blood sugars are as well controlled as possible. • Call your providers if your blood sugars are consistently >200mg/dL • Diet and exercise are critically important!
14. Is there a difference In Severity of CoVid between Type 1 and Type 2 diabetes? • There is not enough data to show any difference between type 1 and type 2. • THE MOST IMPORTANT FACTOR IS GLUCOSE CONTOL and KEEPING BLOOD SUGAR UNDER 180mg/dL
15. Next: tips for managing your diabetes during the Quarantine
16. I’m so STRESSED OUT!!! Could that make my sugar go high? • YES! • Managing mental stress is key to managing your diabetes. • Try 60 seconds of Deep Breathing every 30-60 minutes • Exercise Outdoors when possible • Seek out mental health resources
17. Mental Health • https://www.namidelaware.org/covid19-resources • Talkspace app • Headspace app • Limit news to 2 times a day for a max of 30 min each time. During the rest of the day consider revisiting a hobby, reading a book, calling a friend or relative, go for a walk, take an online class (www.edx.org)
18. Challenges in managing diabetes at home during the CoVid-19 crisis STRESS – “Remain calm and mind your diabetes care & public health advice” SOCIAL DISTANCING does not mean social isolation SCREEN TIME – limit, avoid over stimulation SCHEDULE – make one and stick to it STOCK UP on nutritious foods, non-perishable ; curbside-pickup or delivery, (14 days in case you have to self quarantine) GLUCOSE control is key! Not feeling well – increase self-monitoring of blood glucose (SMBG) STAY in touch with your healthcare provider – DO NOT HESITATE to reach out! Consider tele and phone visits! MEDICATIONS/SUPPLIES – Stock up –delivery, drive through, mail order The time for indulging in stress-eating and stress-snacking is over.
20. FAQs Is ibuprofen safe? Is it safe to take ACE’s/ARBS eg lisinopril, losartan Can I walk outside? Should I go to work?
21. American Diabetes Association Guidelines KNOW YOUR RIGHTS • https://www.diabetes.org/coronavirus-covid- 19/know-your-rights-covid-19 • If you have questions about your legal rights as a person with diabetes at anytime including during this pandemic, • Visit the above website or call 1-800-DIABETES
22. What if I lost my insurance?
23. Assistance with cost of Insulins • www.insulinhelp.org • 833-808-1234 (Lily) • Basaglar, Humalog • 1-844-668-6463 (Novo) • Levemir, Tresiba, Novolog • 1-855-984-6302 (Sanofi) • Lantus, Soliqua, Apidra • Ask these companies about their $99/month program if you do NOT qualify to get the insulin for free • Lily has a $35/month program • Always let your doctor know if your medication is too expensive, he/she will try to find a way to help.
24. Social Distancing = Fewer DEATHS due to COVID, too many have died Please follow recommendations by PUBLIC HEALTH EXPERTS such as those at the CDC
25. CDC Resources for COVID-19 • https://www.cdc.gov/coronavirus/2019- ncov/communication/factsheets.html
26. Thank you The Delaware Diabetes Coalition
27. Like us on Facebook! @DEDiabetesCoalition director@dediabetescoalition.org